A process approach to improving pain management in the emergency department: development and evaluation

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Abstract
Aim—(1) To describe a process approach to the improvement of pain management in emergency departments. (2) To compare analgesia ordering and administration practices for patients with acute fractures before and after implementation of a nurse managed, titrated intravenous narcotic policy. Method—Retrospective chart review of patients with long bone fractures for the years 1993 and 1997. Results—There was a dramatic change in analgesia administration practices away from the intramuscular route in favour of the intravenous route (pConclusion—This study demonstrates that a process approach to improving pain management that resulted in both changes in drug administration and pain assessment and management processes made a significant and sustained change to analgesia ordering and administration practices for patients with long bone fractures in an emergency department.

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